Z158 – Removal of three or more lesions by excision and suture
OHIP Psychiatric Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service provides payment for the removal of three or more Group 1 lesions (e.g., keratosis, pyogenic granuloma) from single or multiple sites by excision and suture, with or without biopsy. This service is not insured if performed for purely cosmetic purposes without any clinical suspicion of disease or malignancy. Refer to Appendix D Surface Pathology for lesion classification. An additional premium E542 is payable when performed outside of a hospital.
When to Use
- Use Z158 when you perform the excision and suture of three or more Group 1 lesions in a single session, as it is a bundled code for multiple removals.
- Choose Z158 over individual billing of Z156 or Z157 when the total count of Group 1 lesions removed reaches the threshold of three.
Common Pitfalls
- Billing Z158 for cosmetic removals without documented clinical suspicion of malignancy or disease is a common cause for audit recovery.
- Attempting to bill Z158 alongside individual lesion removal codes (e.g., Z156) for the same site or session will result in a rejection for duplicate billing.
- Failing to append E542 when the procedure is performed in a clinic or office setting results in the loss of the mandatory out-of-hospital premium.
Billing Tips
- Ensure your operative note explicitly lists the anatomical location and the clinical justification for each of the three or more lesions to satisfy audit requirements for medical necessity.
- Always verify the lesion classification in Appendix D, as Z158 is strictly limited to Group 1 lesions; Group 2 or 3 lesions require different coding.
Effective: April 1, 2026
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
Tattoo removal - (see Appendix D Surface Pathology Section 3).
Removal of any lesions (e.g. keratosis, nevi) for cosmetic purposes and not for any clinical suspicion of disease or malignancy is not an insured service.
Group 1 - e.g. keratosis, pyogenic granuloma (see Appendix D Surface Pathology)
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